Study of platelet-activating factor acetylhydrolase in the perioperative period of patients undergoing cardiac surgery

Shock. 1998 May;9(5):313-9. doi: 10.1097/00024382-199805000-00001.


After operations with cardiopulmonary bypass, patients often show early symptoms of the systemic inflammatory response syndrome (SIRS). Potential mediators of SIRS include the platelet-activating factor (PAF), which has been linked to septic shock and multiple organ dysfunction. We studied the effect of cardiac surgery on PAF acetylhydrolase, the PAF-degrading plasma enzyme, as well as the relationship between the enzyme and the postoperative state of the patients. PAF acetylhydrolase activity decreased by 38+/-8% after instituting cardiopulmonary bypass because of plasma dilution and returned to near-preoperative levels within 6 h postsurgery. After that, enzyme levels decreased again, resulting in a 24+/-12% reduction until at least 3 days postsurgery. Patients in poor postoperative condition (Acute Physiology Score >9) had a lower preoperative PAF acetylhydrolase activity than did normal patients (12+/-4 vs. 17+/-4 nmol min(-1) mL(-1); p < .05). Likewise, patients who developed postoperative SIRS had a lower preoperative PAF acetylhydrolase activity than did patients without SIRS (12+/-3 vs. 17+/-4 nmol min(-1) mL(-1); p < .05). The data suggest that PAF acetylhydrolase deficiency is among the factors associated with postoperative distress after cardiac surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 1-Alkyl-2-acetylglycerophosphocholine Esterase
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Apolipoproteins A / blood
  • Apolipoproteins B / blood
  • Cardiac Surgical Procedures*
  • Cardiopulmonary Bypass*
  • Cholesterol / blood
  • Female
  • Humans
  • Male
  • Middle Aged
  • Phospholipases A / blood*
  • Postoperative Period
  • Reference Values
  • Regression Analysis


  • Apolipoproteins A
  • Apolipoproteins B
  • Cholesterol
  • Phospholipases A
  • 1-Alkyl-2-acetylglycerophosphocholine Esterase